In order to provide patients with the best possible standards of care, it’s important to consider how treatment will impact their oral health long term. Where the dental pulp is affected, a decision-making process is required to ensure that the most appropriate course of treatment is carried out. Ideally, this should avoid the acceleration of the restorative cycle, enabling patients to keep their natural teeth for as long as possible, delaying the need for dental extractions.
Because the UK has an ageing population who are keeping their natural teeth for longer than previous generations, it’s important that clinicians have a good understanding of how best to preserve the health of their patients’ teeth throughout their lives. This will offer patients a far better quality of life, enabling them to eat, speak, and smile confidently into old age.
Previous treatment types
In previous years, dental extractions were a far more common treatment recommendation when a patient had a dental infection. However, there has been a steady decrease in the number of extractions since 2015 – reducing from 63,196 to 42,180 (2022). Many dental professionals will avoid extracting teeth for a wide range of reasons. Depending on its location, a missing tooth can have an effect on aesthetics, having a big impact on patients’ self-confidence, requiring restorative options like dental implants, bridges, or dentures to be considered.
Additionally, a missing tooth can have an influence on function as the surrounding teeth may shift to fill the space. Eventually, this change in alignment could impact patients’ everyday occlusion, as the teeth are crooked. Restorative options for replacing missing teeth can be expensive, and restorations will ultimately require replacement too, this can cost patients more in the long-term.
Prolonging the life of the tooth
When the dental pulp becomes damaged or infected, previously dental extraction would have been the only option. However, root canal treatment offers an alternative. Endodontic treatment enables clinicians to preserve the existing tooth structure, while avoiding extensive restorative treatment which would be required following extraction. Root canal treatment provides the opportunity to extend the life of the tooth. It removes the infected pulp, seals the canals, and provides a sound restoration to protect the remaining natural tooth structure.
Further to this, if the tooth sustains further damage or infections in the future, or the restoration needs replacing, the tooth can often be re-treated, further delaying the need for extraction, and avoiding the unnecessary restorative cycle. In many cases, root canal treatment offers patients a better quality of life when compared to dental extractions, and when performed with high-quality tools, treatment is predictable and causes less pain than extraction and resulting restorations.
Minimally invasive endodontics
Whilst relatively new in the world of dentistry, vital pulp therapy is emerging as an effective, and even less invasive, option for treating dental pulp. It involves removing carious dentine/pulp, and applying restorative material to produce a positive biological response. This enables the pulp to protect itself, without the need to remove it entirely. Not only does vital pulp therapy help to prevent/delay the need for dental extraction, but it helps to preserve the vitality of unaffected pulp. In the long-term, this means that patients keep as much of their natural tooth as possible.
While it may not be an appropriate option for every patient, it is a promising solution for many. Endodontic treatment is a valuable tool, and when performed effectively, it can offer patients excellent outcomes. Using high-quality instruments and equipment can help to improve predictability, reducing the risk of complications like file breakage, and perforations.
Coltene offers clinicians a wide range of endodontic solutions to help improve predictability and produce better outcomes. In particular, the wireless CanalPro X-Move endo motor offers simple handling and great flexibility. It features an integrated apex locator for improved predictability, with continuous rotation and reciprocating motion, enabling it to adapt to the requirements of the case. Further to this, CanalPro X-Move helps to save time thanks to its intuitive user interface and pre-programmed file setting for Coltene files.
Avoiding the acceleration of the restorative cycle is essential for long-term patient care. As patients are keeping their teeth into old age, it’s important to emphasise the importance of prevention and offer minimally invasive options. Where appropriate, vital pulp therapy offers the ability to retain vital pulp, delaying the need for further root canal treatments and restorations. Endodontic treatment enables patients to keep more of their natural teeth for longer, improving quality of life when compared to dental extractions, and delaying the need for more expensive restorative treatments.
References available on request.